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Critically Ill Exam 1 > Fluids And Electrolytes > Flashcards

Fluids And Electrolytes Flashcards

1
Q

What is the normal range for calcium?

A

8.6-10.2

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2
Q

What can lead to falsely low calcium levels?

A

Hypoalbuminemia

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3
Q

What is the corrected calcium equation?

A

Total calcium + [0.8 x (4-albumin)]

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4
Q

When is hypocalcemia considered severe?

A

<7.5 mg/dL

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5
Q

When are oral calcium replacements typically used?

A

Chronically to maintain calcium stores

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6
Q

What should you avoid giving with calcium?

A

Phosphate

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7
Q

For severe hypocalcemia, what is used for treatment?

A

1 g calcium chloride OR 3 g calcium gluconate IV, then slow continuous infusion

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8
Q

What is used for the treatment of hypercalcemia? 3

A
  1. IV hydration
  2. IV diuretics
  3. Hemodialysis
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9
Q

What type of calcium is a vesicant?

A

Calcium chloride

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10
Q

What is the normal range of Potassium?

A

3.5-5

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11
Q

What is most commonly used for the treatment of hypokalemia?

A

Potassium chloride

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12
Q

What are 3 temporary interventions for the treatment of hyperkalemia?

A
  1. Albuterol nebulizer treatments
  2. Regular insulin plus IV dextrose 25g
  3. Sodium bicarbonate
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13
Q

What should not be used to treat hyperkalemia if the patient has renal failure?

A

IV diuretics

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14
Q

What is the normal range for phosphate?

A

2.7-4.5

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15
Q

When is hypophosphatemia considered severe?

A

<1.5

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16
Q

What is used to treat mild and asymptomatic hypophosphatemia?

A

Oral phosphate replacement

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17
Q

What is used to treat significant or symptomatic hypophosphatemia?

A

IV phosphate replacement: sodium phosphate or potassium phosphate

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18
Q

What dose of IV phosphate in mmol, can be used to treat hypophosphatemia?

A

15 mmol

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19
Q

What dose in mmol can be used to treat severe hypophosphatemia?

A

30 mmol

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20
Q

When is calciphylaxis seen?

A

When calcium/phosphate product exceeds 55-60

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21
Q

What is not used for acute management of phosphate?

A

Phosphate binders

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22
Q

What is the normal range of magnesium?

A

1.5-2.4

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23
Q

What is preferred for magnesium replacement?

A

IV magnesium sulfate

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24
Q

When fluid switches from plasma to interstitial (extra vascular) fluid

A

Third spacing

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25
Q

What is the normal serum osmolarity?

A

275-300 mOsm/kg

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26
Q

What is the range for isotonic fluid?

A

250-375

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27
Q

What fluid does not change after infusing it into the body?

A

Normal saline

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28
Q

What can the use of dextrose cause? Why?

A

Excessive third spacing and hyponatremia. Dextrose gets metabolized and leaves nothing behind but water

29
Q

What is the property of normal saline?

A

Purely isotonic

30
Q

What is the breakdown of Na and Cl in normal saline?

A

154 mEq Na, 154 mEq Cl

31
Q

What are the properties of 1/2 NS?

A

Purely hypotonic

32
Q

What is the breakdown of Na and Cl in 1/2 NS?

A

77 mEq Na, 77 mEq Cl

33
Q

What is the mOsm/L for D5W?

A

252 mOsm/L

34
Q

What are the properties of D5W?

A

Begins isotonic, then becomes hypotonic

35
Q

What is the mOsm/L of D5NS?

A

560 mOsm/L

36
Q

What are properties of D5NS?

A

Purely isotonic

37
Q

What is the mOsm/L for D5 1/2 NS?

A

406 mOsm/L

38
Q

What are the properties of D5 1/2 NS?

A

Begins isotonic, then becomes hypotonic

39
Q

What is the mOsml/L for Lactated ringers?

A

273 mOsm/L

40
Q

What are the properties of LR?

A

Purely isotonic

41
Q

What is the mOsm/L for 3% NaCl?

A

1027 mOsm/L

42
Q

What are the properties of 3% NaCl?

A

Purely hypertonic

43
Q

What should you use when giving 3% NaCl?

A

A central line

44
Q

What is used as the “standard” colloid?

A

Albumin

45
Q

What albumin concentration should be used when a patient is hypotensive?

A

Albumin 5%

46
Q

What albumin concentration raises oncotic pressure in the vasculature and draws fluids from the periphery into the vasculature?

A

Albumin 25%

47
Q

What albumin concentration delivers fluids that go and remain in the vasculature?

A

Albumin 5%

48
Q

What is the normal chloride range?

A

97-107 mEq/L

49
Q

What is hyponatremia usually associated with?

A

Decreased serum osmolality

50
Q

What can hyponatremia cause?

A

Neurological effects

51
Q

When treating hyponatremia, you should not increase plasma sodium faster than _________.

A

6-12 mEq/L/day

52
Q

If patients are acutely symptomatic from hyponatremia, what is the maximum increase?

A

1-2 mEq/L/hr

53
Q

What fluid type usually presents with hyponatremia?

A

Hypervolemia

54
Q

What fluid status usually presents with hypernatreamia?

A

Hypovolemia

55
Q

How much sodium is in LR?

A

130 mEq

56
Q

What is another common cause of hyponatremia?

A

SIADH

57
Q

How would you treat hyponatremia?

A

By stopping or changing the unnecessary or inappropriate fluid

58
Q

How would you treat hypernatremia?

A

Adding fluids (iso/hypotonic)

59
Q

What is another common cause of hypernatremia?

A

Diabetes insipidus

60
Q

What can hyperglycemia cause in regards to sodium?

A

Pseudohyponatremia

61
Q

For each 100 mg/dL of glucose above normal, plasma sodium decreases by ___ mmol/L

A

1.6

62
Q

What does SIADH stand for?

A

Secretion of inappropriate anti diuretic hormone

63
Q

What are 5 drugs that can cause SIADH?

A
  1. SSRIs
  2. NSAIDs
  3. Opioids
  4. Antidepressants
  5. Antipsychotics
64
Q

What are the 2 methods for treating SIADH?

A
  1. Fluid restriction to <1500 mL/day
  2. Low dose loop Diuretics + oral NaCl @ doses of 4-16 g/day
65
Q

Disease consisting of decreased secretion of anti diuretic hormone leading to decreased retention of water at the distal tubule

A

Diabetes Insipidus

66
Q

What are 3 ways to treat diabetes insipidus?

A
  1. Hypotonic solutions
  2. Vasopressin analogs
  3. Desmopressin 1-2 mcg IV or SQ BID
67
Q

What is another option to treat diabetes insipidus?

A

Vasopressin infusion

68
Q

How much potassium is in Kphos?

A

22 mEq

69
Q

How much sodium is in Naphos?

A

20 mEq

Critically Ill Exam 1 (7 decks)

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